Sleep, pain, mood and focus problems after a serious car crash
How a trauma psychologist and an injury physician sort through symptoms that overlap
A rough night makes your pain harder to handle. Then the pain wakes you up again. The next day you can’t focus. You snap at someone you love. [1, 2, 3]
After a crash, several things can feed this cycle at once. Injury, concussion, medicines, stress and broken sleep can all be part of it. A trauma psychologist and an injury physician would look at the whole picture. They wouldn’t write off every symptom as ‘just anxiety.’ They also wouldn’t assume each symptom has one single cause. [1, 2, 3]
A good next move is to keep simple notes on how things change. Share them with a clinician who can look at your injuries, medicines, sleep and emotional reactions all together. [1, 2]
Spot the links between symptoms without diagnosing yourself
A possible concussion can change how you think, feel and sleep. Pain can break up your sleep and make it harder to move. Reminders of the trauma can make you more watchful at night. Too little sleep can make you more irritable and less able to focus. Medicine side effects can bring dizziness or sleepiness. You may be dealing with two or more of these at once. [1, 2, 3]
Describe what you notice to your care team. Don’t try to pick the right label yourself. Compare two ways of putting it. ‘My brain is broken’ tells them little. ‘I sleep four hours, wake with shoulder pain and lose track of talks after my evening medicine’ tells them much more. Mention when the symptoms started and whether they’re getting better or worse. [1]
Keep a short daily log
Each day, jot down how long and how well you slept. Note where you hurt and how bad the pain is. Add any medicine changes, your mood and one example of trouble with thinking. Write down what activity you were able to do. [1, 4]
Keep the log brief so it helps your care without turning into one more chore. Bring it to your follow up visits. If writing is hard, ask someone you trust to help. [1, 4]
- Sleep: ‘An hour to fall asleep. Woke up twice from pain. One nightmare.’
- Pain: ‘Neck pain at 6 out of 10 after sitting for 20 minutes. Better after prescribed treatment.’
- Thinking or mood: ‘Missed an appointment reminder. More irritable than usual after a bad night.’
If a symptom gets worse all of a sudden, don’t hold off until a routine visit. Go by the warning signs in your discharge instructions. After a possible head injury, some signs need emergency care. They include a headache that worsens and won’t go away, repeated vomiting and weakness. Seizures, new confusion and trouble waking up also need emergency care. [1]
Guard your sleep while treating pain
Ask your treating clinician if your pain plan is working at night. Also ask if any medicine might affect your sleep or how alert you are. Take medicines only as directed. Talk to a pharmacist before you add a sleep aid, alcohol or any other product. Some medicines can hurt your ability to drive the next day. [3, 5]
Getting up at the same time each day may help. So may a quiet place to sleep and a short routine to wind down. If you have a concussion, stick to the activity and sleep advice from your clinician. If nightmares or trouble sleeping keep going, ask about treatment aimed at those problems. For insomnia that won’t let up, cognitive behavioral therapy for insomnia is one established option. [3, 4]
Lighten the load on your brain for now
Keep all appointments and medicine times on one calendar. Ask for instructions in writing. Say the plan back to your clinician in your own words. Tackle one hard task at a time, with breaks built in. If trouble focusing makes work, driving or child care unsafe, tell your clinician. Line up help until you’ve been checked. [1, 4]
A bad day after some activity gives you information. It’s not a personal failure. Let the care team know what you tried and how your symptoms changed. They can help you adjust how fast you return to things. [4]
Don't overlook your mood
Feeling irritable, sad, afraid or numb can be part of how you respond to stress. These feelings can also come with pain, poor sleep or a concussion. Let your clinician know when your mood is making relationships, treatment or daily care hard. When needed, a trauma clinician can work side by side with your injury care. [1, 2]
Get support right away if you feel hopeless or are thinking of suicide. In the United States, you can call or text 988. If you’re in immediate danger, call 911. [6]
Bring these questions to your next appointment
- Which of my symptoms match the injuries we know about? Which ones need another look?
- Could one of my medicines, or a mix of them, be affecting my sleep, mood or attention?
- What kind of change means I should call sooner? Who keeps the plan in sync across all my clinicians?
You don’t need a tidy explanation before you ask for help. Describing the pattern clearly is enough to get started.
Sources and further reading
- 1CDC: Concussion symptoms and danger signs
- 2VA: Brain injury and trauma symptoms
- 3VA: Sleep problems and trauma
- 4CDC: Recovery after concussion
- 5FDA: Medicines and driving
- 6NIMH: Coping with traumatic events
This is general U.S. health education shaped by trauma psychology and injury medicine. It can’t tell you what is causing a symptom. Follow your discharge instructions, and get personal care for any symptom that is new or getting worse.
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